ReviewLancet regional health. Americas2025
Why have overdose deaths decreased? Widespread fentanyl saturation and decreased drug use among key drivers.
Review in Lancet regional health. Americas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Fentanyl purity and overdose decline: A reexamination of geographic trends.Science advances · 2026Article
- Benefits of Regional Anesthesia Versus Opioids in the Management of Postoperative Pain Following Excision of a Peripheral Nerve Sheath Tumor.Journal of medical cases · 2026Article
- Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement.Addiction (Abingdon, England) · 2026Article
- Fentanyl Purity and Overdose Decline: A Reexamination of Geographic Trends.medRxiv : the preprint server for health sciences · 2026Article
- Contingency Management for Stimulant-Opioid Co-Use: A Systematic Review and Meta-Analysis.Journal of addiction medicine · 2026Article
- Charting the Decline of the Fourth Wave: US Overdose Deaths by Race, Ethnicity, and Substance Involvement.medRxiv : the preprint server for health sciences · 2026Article
- Illicit drug supply, naloxone availability, and overdose mortality in the fentanyl era: a systematic review.Health affairs scholar · 2026Review
- Social Determinants of Health and 1-Year Buprenorphine Initiation Among Justice-Involved Veterans.JAMA network open · 2026Article
- Burden of overdoses among persons with opioid use disorder in the United States, 2025-2028: a simulation modeling study.Lancet regional health. Americas · 2026Article
- Assessing knowledge, attitudes, and barriers to opioid overdose among college students.BMC public health · 2026Article
- Understanding Practitioner Comfort and Educational Priorities for Safe Opioid Prescribing: A Repeated Cross-Sectional Study.Journal of pain research · 2026Article
- "Because we're the experts": centering the expertise of people who use drugs to identify and propose solutions for overdose prevention.Harm reduction journal · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
While overdose deaths remain high in the United States (U.S.), national data show a 25.0% decline in overdose deaths from the year ending in March 2025 compared to the previous year. Reductions since 2015 in the population exposed to overdose risk through drug use may have until recently been offset by an increased per-person mortality risk, driven by replacement of heroin with fentanyl in the drug supply. We estimated overdose deaths and counterfactual scenarios from 2016 to 2023. An estimated 109,783 additional people would have died from opioid overdose if the population exposed to opioid overdose risk had remained constant rather than declining; an estimated 260,024 fewer people would have died from overdose if probability of fentanyl involvement in opioid overdose deaths had remained constant rather than increasing. Fentanyl's representation in the U.S. drug supply appears to be a key driver of overdose trends. A declining population exposed to overdose risk over the last decade may be related to prior deaths and to evidence-based efforts to prevent substance use and opioid use disorder.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.